Northern Ireland Assembly Flax Flower Logo

Northern Ireland Assembly

Monday 12 February 2001 (continued)

Madam Deputy Speaker:

Mr Kane, may I hear your question?

Mr Kane:

Can the Minister give the House a constructive commitment? How does she intend to deal with this serious matter?

Ms de Brún:

With regard to waiting lists, I am advised by the trust that the five people who are currently awaiting treatment were diagnosed last week and are scheduled to be admitted this week. I cannot comment on the specific case to which the Member refers, as I do not have the necessary details. I have frequently highlighted the need for additional resources for the entire range of health and social services, and I will continue to do so. It is clear that I am addressing this issue.

Ms Gildernew:

The problem of waiting lists does not only apply to neurosurgery. There are an estimated 50,000 people on waiting lists. May I ask what the Minister is doing to try to address this matter?

Ms de Brún:

Tackling of waiting lists is one of my key priorities. This long-standing problem is the result of years of underfunding. There is no quick fix. I have already issued a comprehensive framework for services which sets out a longer-term, more strategic approach to making real and sustainable reductions in waiting lists. This is backed by an additional investment of £5 million this year, and the Budget proposals for next year mean that there will be an extra £8 million available for further action.

Rev Robert Coulter:

Will the Minister provide details of the numbers on waiting lists for major surgery at acute hospitals in Northern Ireland today and further indicate any percentage improvements from the previous year?

Ms de Brún:

The Member will be aware that without advance notice such an answer detailing the range of hospitals and percentages cannot be available. However, if the Member wishes to write to me, I can pick up on that.

Department Literature (Languages)


Mr Neeson

asked the Minister of Health, Social Services and Public Safety to outline her policy on publishing literature by her Department in languages other than English; and to make a statement.

(AQO 760/00)

Ms de Brún:

Tá rún daingean agam cumarsáid éifeachtach a dhéanamh le daoine i ngach foilseachán de chuid mo Roinne. Aithním gur gá nó gur mian le roinnt earnálacha sa phobal teacht ar ábhar i dteangacha seachas Béarla; agus, i gcás daoine a bhfuil míchumas céadfach agus foghlama orthu gur gá teacht ar eolas i bhformáid eile seachas cló. Cuirfidh mo Roinnse doiciméid thábhachtacha ar fáil i gcló mór, in Braille, ar chlostéip, i nGaeilge agus i Sínis agus scrúdóidh sí éilimh maidir le haistriúcháin i dteangacha mionlach eitneach eile.

Tá sé beartaithe ag mo Roinn ina scéim chomhionannais na socruithe sin a mheasúnú roimh mhí an Mheithimh 2002 le fáil réidh le bacainní ar chumarsáid éifeachtach.

I am fully committed to effective communication with the public in all my Department's publications. I recognise the need or wish of some sections of the public to access material in a language other than English and, in the case of people with sensory and learning disabilities, to access information in a format other than print.

My Department will make key documents available in large print, Braille, audio cassette, Irish and Chinese and will consider requests for translations into other minority ethnic languages. In its equality scheme, my Department has also undertaken to assess these arrangements before June 2002 with a view to removing any barriers to effective communication.

Mr Neeson:

Does the Minister agree that Northern Ireland is now home to a growing number of people from different ethnic backgrounds and that it is vital that they understand information distributed by her Department? Can she assure the House that the health boards are consistent in the provision of these facilities?

Ms de Brún:

The concept of health and social services provision is not tied to one language and we must provide health and social services to a wide range of service users with regard to community background, social class and language. A modern health service must be able to cater for this, and we will endeavour to do so. We do not have consistency from one board to another because provision depends on who is likely to need whatever service in a particular area. If there is a predominance of one community in one board area, that should influence the provision of translated documents. The boards take the subject matter into account and consider whether a document is likely to be of relevance to particular linguistic groups in their areas.

Dr Adamson:

Go raibh maith agat. Will the Minister assure us that she will approach this matter on the basis of need rather than ideology? Will she indicate how much her Department has spent since she took office on the translation and publication of literature in the Irish language and what the figures are for Ulster-Scots and ethnic minority languages?

Ms de Brún:

My approach is based on the need to provide services to a diverse community. We are looking at the Good Friday Agreement and at what it says about the use of languages, and I will take that into account.

For the current financial year, from April 2000 to date, translation costs are as follows: Irish, £17,549; and Chinese, £4,289 - a total of £21,838.

The documents 'Investing for Health' and 'Building the Way Forward in Primary Care' are currently being translated into Ulster-Scots. We have had 27 requests for 'Investing for Health' and 10 requests for 'Building the Way Forward in Primary Care'. We have not yet been billed for these translations, but I will give the Member the figures as soon as they are available.

Mr Paisley Jnr:

Does the Minister accept that every month she is wasting vital resources by duplicating her material in the Irish language? She has made her puerile political point. Will she now stop wasting these resources, which could have been spent on at least five hip replacement operations? Will she now start to allocate her resources to ensure that patients come first and not the Republican agenda?

Ms de Brún:

As for the perennial hip-replacement question, may I suggest that it is not I who is making puerile political points. I have already explained the need to provide services in a pluralist society to a wide range of service users. Once and for all, can I put to rest this issue that Ian Paisley Jnr raises again and again. Translations are paid for out of my Department's administration budget. That is quite distinct and separate from the general Health, Social Services and Public Safety budget, to which he constantly refers.

3.15 pm

Foster Parents


Mr Ford

asked the Minister of Health, Social Services and Public Safety to give her assessment of the recruitment and retention of foster parents; and to make a statement.

(AQO 769/00)

Ms de Brún:

I mí Mheán Fómhair 1999 sheol mo Roinn cód cleachtais maidir le caighdeáin chúraim altrama agus maidir le cúramóirí altrama a earcú, a mheasúnú, a fhormheas, a oiliúint agus a bhainistiú agus le tacaíocht a thabhairt dóibh. Is é an cuspóir a bhí leis ná dea-chleachtas agus seirbhísí ardchaighdeáin altrama a chur chun cinn. Déanfaidh gach iontaobhas sláinte agus seirbhísí sóisialta iniúchadh ar ball ar an tseirbhís chúraim altramais atá aige i gcoinne na gcaighdeán seo. Nuair a bhéas an t-iniúchadh seo críochnaithe beidh sé ar mo chumas gach gné den tseirbhís luachmhar seo a mheasúnú.

There have been some difficulties with the recruitment and retention of foster carers. The health and social services trusts are aware of those problems and are endeavouring to address them. In September 1999 my Department launched a code of practice on the recruitment, assessment, approval, training, management and support of foster carers and standards for foster care, both of which were designed to promote good practice and a high-quality fostering service. Each trust will shortly undertake an audit of its foster care service against those standards. When that has been completed I will be in a position to assess all aspects of this valuable service.

Madam Deputy Speaker:

Mr David McClarty. Oh, Mr David Ford.

Mr Ford:

Thank you, Madam Deputy Speaker. I thought you had forgotten me.

Madam Deputy Speaker:


Mr Ford:

I thank the Minister for her response, although I am slightly worried when she talks about "some difficulties" with the recruitment and retention of foster parents. If she were using the language that social workers use, she would not be using a euphemism such as "some difficulties". In view of the serious difficulties that exist in recruiting and retaining foster parents, is it acceptable that little seems to have been done since the 1999 report to which she referred? What is she going to do to ensure that trusts take serious action now, including looking at the different methods used in other jurisdictions, to ensure that we can increase the number of foster parents and improve the care service offered to our children?

Ms de Brún:

I am aware that some 200 additional foster carers are needed. Last September the Foster Care Association organised a foster care awareness week, which was designed to encourage recruitment. The response to that initiative is now being assessed, and we will be interested in hearing its outcome. I assure the Member that my Department will give priority to the development of foster care services. Moreover, all the boards have indicated that the development of foster care services is among their priorities, as we have asked.

With the help of the national Foster Care Association and the necessary computer support, we can assist the trusts. We can ensure that the audit will address good practice that has been developed elsewhere, as well as the standard audit, which we will be able to track.

Mr McClarty:

Thank you, Madam Deputy Speaker. I understand completely the difficulty you had in distinguishing between me and David Ford.

Last September, when 322 children were waiting for foster homes in Northern Ireland, the Minister encouraged more people to become foster parents. Can the Minister indicate to the House how many children are presently waiting for foster homes and how many of those are still on the waiting list from last September? Furthermore, can the Minister indicate by constituencies, areas of (a) poor recruitment and (b) retention difficulties?

Ms de Brún:

Perhaps the Member would make that a written question rather than an oral one. Such detailed questions cannot possibly be answered without advance notice. The Members who are putting them as oral questions, rather than as written ones, know that they cannot possibly be answered. However, I will supply the necessary details for each constituency. If the Member writes to me, I will supply that information.

We are endeavouring to produce increased support for foster carers and to increase the number of foster carers. That has been addressed in the Programme for Government. We are also trying to ensure that there is increased support to overcome difficulties in the retention of foster carers.

Ms Ramsey:

Go raibh maith agat, Madam Deputy Speaker. Does the Minister agree that funding is a test for the Executive, not only on the delivery of foster care but on children's services as a whole? Is there a different level of financial support -

Madam Deputy Speaker:


Ms Ramsey:

Are there different levels of financial support for foster carers across trusts?

I thank Mr Paisley for his attention.

Ms de Brún:

I have frequently and consistently highlighted the considerable need for greater resources across a wide range of health and social services, including children's services. In advance of the Budget allocations this year, I bid for what I considered to be necessary. I also made it clear that I did not think it possible for the Executive to address that this year because of competing priorities. We are now taking up that question and examining the need. The kind of examination that the Executive are now making of needs across the health and social services should help us to address the level of budgetary allocation to health, social services and public safety for the future.

On the question of variation between trusts, some concerns have been expressed about the payment of allowances and expenses associated with caring for foster children. One of the 25 foster care standards deals with that aspect of the service. The audit that is about to commence will track the performance of the trusts in that.

Children's Health Care:
Finance Allocations


Mr Beggs

asked the Minister of Health, Social Services and Public Safety to confirm that the third report from the capitation formula review group is proposing that for every £100 allocated to children's health care in Northern Ireland, only £77 will be allocated per child in the Northern Health and Social Services Board area while £122 per child will be given to some other areas; and to make a statement.

(AQO 785/00)

Ms de Brún:

Ceapadh an fhoirmle le cinntiú go léiríonn leithroinnt na n-acmhainní na leibhéil dhifriúla riachtanais i gceantair éagsúla. Is amhlaidh, mar sin, gur mó na hacmhainní a leithroinnfear ar cheantair inár mó na leibhéil ganntanais agus riachtanais eile. Is mar seo a chinntíonn an fhoirmle go bhfaigheann bord a bhfuil níos mó páistí i ngátar faoina chúram go leor acmhainní leis an leibhéal céanna cúraim a sholáthar do pháiste i ngátar agus a thiocfadh le bord ar bith eile a sholáthar. Ós rud é go bhfuil leibhéal an ghanntanais i bhfad níos lú, ar meán, i gceantar Bhord an Tuaiscirt, is lú an t-airgead atá de dhíth le tabhairt faoi leibhéal an ghanntanais ann.

The formula is designed to ensure that the allocation of resources reflects the different levels of need in different areas. Areas with higher levels of deprivation and other needs will be allocated correspondingly more resources. In this way, the formula ensures that a board with more needy children receives enough resources to provide the same level of care to a needy child as can be provided in any other board. As the level of deprivation is, on average, much lower in the Northern Health and Social Services Board area, it requires less money to address the level of need. It is for this reason that it has the lowest average allocation per child in the population for children's social services in the family and childcare programme.

Mr Beggs:

Can the Minister confirm that the overall effect of the proposed formula changes will result in the Northern Board being short several million pounds compared to the funding it would have received if the current formula was simply updated using current demographic factors?

Does the Minister accept that the criteria create a huge disparity between different board areas in family and childcare funding? Does she also recognise that the formula does not take account of all homes in receipt of income support, those forced to live in private rented accommodation or parents in low-paid employment living in poor-quality private housing? Does the Minister accept that the weighting is out of character with all other factors in this proposed document? I contend that the disparity is huge and needs to be re-addressed.

Ms de Brún:

The figures on the overall impact of the boards' shares and the proposed changes to the formula are not yet finalised. However, if the transitional relief currently being given to the Southern Board to phase the last formula changes is excluded, the current assessment is that the Northern Board's share of resources will increase from 23·69% to 23·70%.

The Western Board's share will increase from 16·53% to 16·69%. The Southern Board's share will remain constant at 17·67%. The Eastern Board's share will reduce from 42·11% to 41·94%. There may still be some further adjustments, based on the outcome of consultation.

With regard to the matter of needs weighting, considerable research has been done into how needs and other weightings for gender and age should be worked out. Therefore I cannot accept that there are any negative aspects to the way in which this is carried out.

On the contrary, it would be wrong for us to continue with a dated formula which does not take account of the up-to-date information we now have on the effects of age, gender and deprivation on the need for resources. We now also know much more about the impact of rural consideration on the costs faced by boards.

Primary Care (Mid Ulster)


Mr Armstrong

asked the Minister of Health, Social Services and Public Safety to give her assessment of primary care provision in Mid Ulster; and to make a statement.

(AQO 779/00)

Ms de Brún:

Is é an cuspóir atá leis an soláthar cúraim phríomhúil i Lár Uladh go mbeidh teacht réidh ag an phobal ar réimse iomlán seirbhísí cúraim phríomhúil ar fud an cheantair.

The primary care provision in Mid Ulster is designed to offer good access and coverage for the population of the area to the full range of primary care services.

Mr Armstrong:

Following the Minister's announcement this morning that she will continue to provide high levels of funding, can she advise us what criteria are used when assessing the viability of primary care sites? Can I be assured that the rural nature of my constituency, coupled with poor road infrastructure, will be given due weight in her thinking? Does the Minister accept that healthcare provision must be seen in the round and that, no matter how satisfactory primary care may be in Mid Ulster, this provision is undermined by the inadequacy of hospital services?

Ms de Brún:

I have indeed said that I will endeavour to make improvements and to ensure the highest quality services. I now re-affirm that commitment to the Mid Ulster area.

In answer to the question about roads, interdepartmental consultation on the development of the Department for Regional Development's transportation strategy is ongoing. Work is also progressing on the health impact on that strategy. That will also take into account the need to look at health matters when developing road structures.

We are endeavouring to improve primary care services in the Mid Ulster area. We recently funded two innovative pilot projects, which were put forward by the Homefirst Community Trust, across the entire Mid Ulster area.

One of these is aimed at improving access to dental care for housebound people; this has an effect on the Member's wider concern about the impact of the road infrastructure on health. We have also funded an initiative on out-of-hours community mental health. It is hoped that these will bring benefits that can be replicated in other areas.

3.30 pm

In addition, the Northern Health and Social Services Board has supported the development of a major new GP premises in Magherafelt and provided improvement grants for substantial extensions and renovations to the Coagh and Stewartstown surgeries. The Member will also be aware that the Department funds the Mid Ulster commissioning pilot scheme, which is undertaking a variety of initiatives, such as the local medical orthopaedic clinic, an elderly needs assessment project and work on prescribing and outpatient waiting times. I hope that that gives an indication of our absolute commitment to primary care services in the Mid Ulster area.

Acute Hospital Services
(Tyrone and Fermanagh)


Mr Gibson

asked the Minister of Health, Social Services and Public Safety to give her assessment of the future provision of acute hospital services in the West Tyrone and Fermanagh and South Tyrone parliamentary constituencies.

(AQO 750/00)

Ms de Brún:

Tá mé ag dréim leis go mbeidh an grúpa aithbhreithnithe neamhspleách a bhunaigh mé sa samhradh seo caite ag cur tuarascála chugam ar fhorbairt seirbhísí ospidéal sa todhchaí. Ní bheadh sé cuí agam tuairim ar bith a nochtadh ar sholáthar seirbhísí géarmhíochaine ospidéal i gceantar ar bith go dtí go mbeidh tuarascáil an ghrúpa aithbhreithnithe neamhspleách curtha faoi mo bhráid.

I expect the acute hospitals review group, which I established last summer, to report on the future development of hospital services. It would be inappropriate for me to offer any comment on the future provision of acute hospital services in any area before the independent group has submitted its report. However, I assure the Assembly that I am committed to the development of our hospital services in a way that ensures access to high-quality care for all those who need it.

Mr Gibson:

When does the Minister expect the acute hospitals review group to report? Will it be before or after Easter? The Erne Hospital and the Tyrone County Hospital are in decline, and the South Tyrone Hospital has gone. We are totally dependent on hospitals that are 60 to 70 miles away.

Ms de Brún:

Although I cannot anticipate what the group may say about the Erne Hospital, Tyrone County Hospital, or any other hospital, I am committed to the development of services in a way that ensures access to high-quality care for those who need it. I have clearly said that I wish to see present services maintained until the review group reports.

Until those longer-term decisions are taken, I expect every effort to be made to maintain services in existing hospitals. For example, I refer the Member to the contingency agreement that existed between the Sperrin Lakeland Health and Social Services Trust and the Western Health and Social Services Council for gynaecology and female surgical services at the Erne Hospital. That temporary measure ended on 5 February, when the gynaecology ward reopened and elective surgery resumed.

I cannot say exactly when the acute hospitals review group will report to me, nor if it will be before or after Easter. First, it is an independent review group, and secondly -

Madam Deputy Speaker:

Time is up. We must move on.


Finance and Personnel

Madam Deputy Speaker:

Question 6.

Mr Dodds:

On a point of order, Madam Deputy Speaker. Why are we jumping to question 6?

Madam Deputy Speaker:

The first five Members on the list to ask questions were not in the Chamber.

Mr Dodds:

Patricia Lewsley is present, and she is on the list at question 2.

Madam Deputy Speaker:

I did not see Mr Dallat in the Chamber when I called, nor was I aware that Ms Lewsley was in the Chamber. I will go back.

Public Expenditure:
Comptroller and Auditor General and
Public Accounts Committee Scrutiny


Mr Dallat

asked the Minister of Finance and Personnel to detail the steps he is taking to ensure that Government Departments address issues which are raised in reports by the Comptroller and Auditor General and scrutinised by the Public Accounts Committee.

(AQO 770/00)

The Minister of Finance and Personnel (Mr Durkan):

It is each Department's duty to consider the Committee's reports that relate to it and to provide answers to any issues raised. That is done in the form of a memorandum of reply that is laid by the Department of Finance and Personnel before the Assembly. My officials ensure that the relevant Department addresses all issues raised in the Committee's reports in the memorandum. In addition, they contact the Departments annually to confirm that all commitments given in such memoranda have been addressed and implemented as appropriate.

Mr Dallat:

Can the Minister assure the House that reports prepared by the office of the public auditor are agreed without unnecessary delay so that the issues they raise can be scrutinised by the Public Accounts Committee and acted upon? That would ensure that the Assembly can make real changes in the interests of value for money and improved services to the wider community.

Mr Durkan:

It is important that reports by the Comptroller and Auditor General are dealt with quickly, as the Member suggests. However, it is worth taking some time to ensure that the relevant facts of the case are available and interpreted accurately, rather than have them be the subjects of likely dispute when it comes to later consideration. Taking time to make sure that relevant facts are properly established and understood should not be used to impede the process of scrutiny by the Comptroller and Auditor General or the Public Accounts Committee.

Executive Programme Fund (Children)


Ms Lewsley

asked the Minister of Finance and Personnel to detail how the Executive programme fund relating to children can be accessed.

(AQO 801/00)

Mr Durkan:

At its meeting on 25 January, the Executive agreed a process for making allocations from the five Executive programme funds. Departments have been provided with guidance on preparing bids for projects that might receive support from the funds, and they have been asked to submit proposals by mid-February. Following assessment of those, the Executive will announce their decision on allocations.

The Executive have agreed to put in place special measures for the children's fund to allow voluntary sector projects to benefit from it. An interdepartmental working group is being established to consider and implement the arrangements needed for that.

Ms Lewsley:

Given that the First Minister and the Deputy First Minister announced the appointment of the new commissioner for children, can the Minister outline the role that the commissioner will play, if any, in relation to this fund?

Mr Durkan:

The First Minister and the Deputy First Minister recently announced the terms of reference for the proposed children's commissioner's remit, which will be informed by widespread consultation. The specific relationship between the proposed commissioner and the children's fund will be developed in the light of that consultation.

Mr B Bell:

Will the Minister advise Members of the mechanisms that will be put in place to make sure that funding goes where it is needed, and will he assure me that funding will not be held up by the bureaucracy of empire-building organisations acting as intermediators?

Mr Durkan:

The arrangements being made will be brought forward as a result of the interdepartmental working group that I indicated would work particularly with the children's fund. The Executive have agreed some broad approaches to the question of their programme funds at large, and I hope that Departments will make meaningful bids.

In this first round, the bids will probably be more mono-departmental than multi-departmental, but the aim is to make sure that we move the funds forward in ways that target need. We are quite clear that the programme funds are there to make sure that there is a new strategic impetus to measures and that due regard is shown to targeting social need.

Rating Policy Review


Mr Fee

asked the Minister of Finance and Personnel to confirm that the proposed review of rating policy will provide an opportunity for consultation outside government.

(AQO 800/00)


Mr Byrne

asked the Minister of Finance and Personnel to confirm that the review of rating policy will examine the impact of the existing policy in terms of equality and targeting social need as well as the needs of small businesses.

(AQO 798/00)

Mr Durkan:

With permission, I will take questions 3 and 13 together.

The review of rating policy will involve consultation with the public so that views and proposals can be considered. The review will be comprehensive and will include consideration of the existing rating policy's impact on equality and targeting social need. I cannot pre-empt the outcome of the review, but I assure Members that rates issues such as the needs of small businesses will be considered in the review. The target date for the completion of the review is spring 2002.

Mr Fee:

I thank the Minister for his reply and for confirming how quickly and expeditiously the review will be carried out. The speed at which he works has already caught out a number of Members in the last couple of minutes, but I commend him for his industry.

Will the Minister confirm that a principal function of the review is to ensure that the burden of debt will be shared across all sectors? That is particularly important in situations where relief is necessary to ensure that small businesses can operate, where employment and jobs are protected and where people on low incomes cannot afford to pay the rates. Will the Minister confirm that those who are most vulnerable will be protected and that those in a position to pay will pay the lion's share.

Mr Durkan:

The review will attempt to examine all the issues involved in rating policy. Additional money - above and beyond what the Treasury gives us - is required, and rates are the means to achieve that. Therefore we need to raise revenue by whatever revised or remodelled rating policy and system we have.

However, the review should be used to examine equity and effectiveness and to ensure that we levy rates in ways which do not place an undue burden on households that can ill afford such a burden or on any particular business sectors as distinct from others that might be better able to afford to make a contribution.


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